RESUMEN
The second hyperpolarizability (γ) of the H2 molecule was measured by gas-phase electric field induced second harmonic generation at the frequencies of the one-photon resonance for the 3-0 Q(J) overtone transitions (v, J = 0, J â 3, J for J = 0, 1, 2, and 3). The magnitude of the resonant contribution to γ was measured with 2% accuracy using the previously determined non-resonant γ for calibration. Pressure broadening and frequency shift for the transitions were also measured. A theoretical expression for the resonant vibrational γ contribution in terms of transition polarizabilities is compared to the observations. The measured γ resonance strength is 4%-14% larger than the results obtained from this theoretical expression evaluated using ab initio transition polarizabilities.
RESUMEN
Monoclonal antibodies against the immune checkpoint programmed cell death receptor 1 (PD-1) improve the hosts' antitumor immune response and have showed tremendous promise in the treatment of advanced solid tumors and hematologic malignancies. Reports of serious autoimmune dermatologic toxicities from immune checkpoint blockade therapy, however, are emerging. We report our experience with five patients who presented with pruritic vesicles and blisters on the skin while treated with anti-PD-1 antibody immunotherapy with either nivolumab or pembrolizumab. Four of the patients' skin biopsies revealed subepidermal bullae with immunohistochemical study for type IV collagen labeling the floor of the blister cavity and direct immunofluorescence studies (in three of the four patients tested) decorated linear IgG and C3 immune deposits on the blister roof, diagnostic of bullous pemphigoid. One patient developed bullous erythema multiforme. All patients had partial or complete resolution of skin lesions following treatment with systemic corticosteroid and cessation of checkpoint blockade. Recognition and treatment of rare immune-related bullous dermatologic toxicities will become increasingly important as more patients are treated with effective and newer immune checkpoint blockade therapy.
Asunto(s)
Anticuerpos Monoclonales Humanizados/efectos adversos , Anticuerpos Monoclonales/efectos adversos , Antineoplásicos/efectos adversos , Erupciones por Medicamentos/etiología , Enfermedades Cutáneas Vesiculoampollosas/inducido químicamente , Anciano , Erupciones por Medicamentos/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Nivolumab , Receptor de Muerte Celular Programada 1/antagonistas & inhibidores , Enfermedades Cutáneas Vesiculoampollosas/patologíaAsunto(s)
Dermatosis Bullosa IgA Lineal/diagnóstico , Recuento de Linfocito CD4 , Dapsona/uso terapéutico , Técnica del Anticuerpo Fluorescente Directa , Antagonistas del Ácido Fólico/uso terapéutico , Infecciones por VIH/diagnóstico , Infecciones por VIH/inmunología , Humanos , Inmunoglobulina A/inmunología , Dermatosis Bullosa IgA Lineal/tratamiento farmacológico , Masculino , Persona de Mediana EdadAsunto(s)
Infecciones por VIH/inmunología , Herpes Simple/diagnóstico , Síndrome Inflamatorio de Reconstitución Inmune/diagnóstico , Escroto/patología , Úlcera Cutánea/diagnóstico , Administración Tópica , Adulto , Terapia Antirretroviral Altamente Activa/efectos adversos , Terapia Antirretroviral Altamente Activa/métodos , Antivirales/uso terapéutico , Biopsia con Aguja , Cidofovir , Citosina/análogos & derivados , Citosina/uso terapéutico , Diagnóstico Diferencial , Estudios de Seguimiento , Infecciones por VIH/diagnóstico , Infecciones por VIH/tratamiento farmacológico , Herpes Simple/tratamiento farmacológico , Herpes Simple/patología , Humanos , Síndrome Inflamatorio de Reconstitución Inmune/tratamiento farmacológico , Inmunohistoquímica , Masculino , Organofosfonatos/uso terapéutico , Escroto/efectos de los fármacos , Índice de Severidad de la Enfermedad , Úlcera Cutánea/tratamiento farmacológico , Úlcera Cutánea/virología , Resultado del Tratamiento , Cicatrización de Heridas/efectos de los fármacos , Cicatrización de Heridas/fisiologíaRESUMEN
This study sought to identify barriers to treatment in children with chronic inflammatory skin disease, particularly those with atopic dermatitis, psoriasis, and acne vulgaris. Caregivers of 101 patients seen in the Children's Specialty Group Division of Dermatology, Children's Hospital of The King's Daughters, Norfolk, Virginia, completed an 11-item Likert scale questionnaire. This survey addressed complexity and time requirements for treatment, medication cost, vehicle formulation, perceived safety, and caregiver understanding of chronicity of skin disorders. Parents and caregivers indicated that adequate instructions for using the medications were provided but that they felt less comfortable with treating their child's skin disease during a severe flare. The complexity of treatment programs, time required to apply medications, and vehicle type were not considered prohibitive factors. Caregivers were concerned about the cost and safety of prescribed medications and had a less understanding of the chronicity of inflammatory skin disorders.
